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The Ankle Brachial Index Is Associated with Leg Function and Physical Activity: The Walking and Leg Circulation Study

Mary McGrae McDermott, MD; Philip Greenland, MD; Kiang Liu, PhD; Jack M. Guralnik, MD, PhD; Lillian Celic, BS; Michael H. Criqui, MD, MPH; Cheeling Chan, MS; Gary J. Martin, MD; Joseph Schneider, MD, PhD; William H. Pearce, MD; Lloyd M. Taylor, MD; and Elizabeth Clark, MD
[+] Article and Author Information

From the Feinberg School of Medicine at Northwestern University and Catholic Health Partners, Chicago, Illinois; National Institute on Aging, Bethesda, Maryland; University of California at San Diego School of Medicine, San Diego, California; Evanston Hospital, Skokie, Illinois; and Oregon Health Sciences Medical Center, Portland, Oregon.


Acknowledgments: The authors thank the study participants and their physicians for their time and effort.

Grant Support: By the National Heart, Lung, and Blood Institute (R01-HL58099), the Robert Wood Johnson Foundation, and the National Center for Research Resources, National Institutes of Health (RR-00048). Dr. McDermott is a recipient of an Established Investigator Award from the American Heart Association.

Requests for Single Reprints: Mary McGrae McDermott, MD, 675 North Saint Clair, Suite 18-200, Chicago, IL 60611.

Current Author Addresses: Drs. McDermott and Martin: 675 North Saint Clair, Suite 18-200, Chicago, IL 60611.

Drs. Greenland and Liu and Ms. Chan: 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611.

Dr. Guralnik: Gateway Building, Room 3-C309, 729 Wisconsin Avenue, Bethesda MD, 20892.

Dr. Criqui: 9500 Gilman Drive, La Jolla, CA 92093-0607.

Ms. Celic: 676 North Saint Clair, Suite 200, Chicago, IL 60611.

Dr. Schneider: 9977 Woods Drive, Skokie, IL 60077.

Dr. Pearce: 675 North Saint Clair, Galter 10–105, Chicago, IL 60611.

Dr. Taylor: Department of Vascular Surgery, Oregon Health & Science University, Vascular Surgery—OP11, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201-3098.

Dr. Clark: 2520 North Lakeview, Chicago, IL 60614.

Author Contributions: Conception and design: M.M. McDermott, P. Greenland, K. Liu, J.M. Guralnik, M.H. Criqui, G.J. Martin, J. Schneider, L.M. Taylor.

Analysis and interpretation of the data: M.M. McDermott, P. Greenland, K. Liu, J.M. Guralnik, M.H. Criqui, C. Chan, L.M. Taylor.

Drafting of the article: M.M. McDermott, J.M. Guralnik, M.H. Criqui, G.J. Martin, J. Schneider.

Critical revision of the article for important intellectual content: M.M. McDermott, P. Greenland, J.M. Guralnik, L. Celic, M.H. Criqui, C. Chan, G.J. Martin, J. Schneider, W.H. Pearce, L.M. Taylor, E. Clark.

Final approval of the article: M.M. McDermott, P. Greenland, K. Liu, J.M. Guralnik, M.H. Criqui, J. Schneider, L.M. Taylor.

Provision of study materials or patients: L. Celic, G.J. Martin, J. Schneider, W.H. Pearce, E. Clark.

Statistical expertise: K. Liu, J.M. Guralnik, M.H. Criqui, C. Chan.

Obtaining of funding: M.M. McDermott, P. Greenland, M.H. Criqui, L.M. Taylor.

Administrative, technical, or logistic support: P. Greenland, L. Celic, C. Chan, G.J. Martin.

Collection and assembly of data: M.M. McDermott, L. Celic, C. Chan.


Ann Intern Med. 2002;136(12):873-883. doi:10.7326/0003-4819-136-12-200206180-00008
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We identified 2662 potential participants from the three noninvasive vascular laboratories and 467 from general medicine practice. Figure 1 shows the reasons for nonparticipation of 2389 patients. Among the participants, 460 had peripheral arterial disease and 280 did not have peripheral arterial disease. Figure 2 shows the numbers of study participants who completed each functional measure.

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Figure 1.
Description of identified potential study participants.*

*PAD = peripheral arterial disease. †The Methods section provides details about the excluded patients.

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Figure 2.
Associations between the ankle brachial index and functional outcomes.A.B.C.D.E.F.

Stopping during 6-minute walk. Distance walked in 6 minutes. 7-day physical activity level, as measured by Caltrac accelerometer. Standing balance (full tandem stand). 4-meter walking velocity at usual and fastest pace. Summary performance score, on a scale of 0 to 12 (12 = best). This score combines data from the walking velocity, repeated chair rises, and standing balance tests.

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Summary for Patients

Associations between Peripheral Arterial Disease and Leg Function

The summary below is from the full report titled “The Ankle Brachial Index Is Associated with Leg Function and Physical Activity: The Walking and Leg Circulation Study.” It is in the 18 June 2002 issue of Annals of Internal Medicine (volume 136, pages 873-883). The authors are MM McDermott, P Greenland, K Liu, JM Guralnik, L Celic, MH Criqui, C Chan, GJ Martin, J Schneider, WH Pearce, LM Taylor, and E Clark.

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